Orange Nation Participant Release & Covenant
Email address *
Name *
Participant Release Form: I understand that parts of the 2020 ORANGE NATION YOUNG ADULT SERVANT EVENT may be physically demanding. I am in good health and am not under a physician’s care for any conditions, disclosed or otherwise, that may hinder my ability to participate in physical activity. I recognize and assume the inherent risk of physical injury that could occur during such programs. I hereby release ORANGE NATION Young Adult Ministry, its leadership staff, Camp Restore, Detroit and its staff members, Mt Calvary Lutheran Church and staff and the Lutheran Church Missouri Synod and its president and board of directors and staff from all activities of the 2020ORANGE NATION YOUNG ADULT SERVANT EVENT. I grant the 2020 ORANGE NATION YOUNG ADULT SERVANT EVENT and acting media staff the right to use, reproduce, assign and distribute photographs, films, videotapes, digital and sound recordings of myself for use in materials they may create for the purpose of promoting the programs of Young Adult Ministry in the LCMS. In case of accident or emergency, I authorize the leaders of the 2020 ORANGE NATION YOUNG ADULT SERVANT EVENT or their designated representative, to consent to an X-ray examination, anesthetic, medical, surgical, or dental diagnosis or treatment, and hospital care to be rendered under the general or special supervision and on the advice of any physician or dentist licensed under the Medical Practice Act or the medical staff of a licensed hospital, whether such diagnosis or treatment is rendered at the office of said physician or at said hospital. I understand that I am liable and agree to pay all costs and expenses incurred in connection with such medical and dental services rendered pursuant to this authorization. Should it be necessary for me to return home due to medical reasons or otherwise, I understand that I shall assume all transportation costs. *
PARTICIPANT COVENANT: 1. As Christians, we will treat each other with love and respect, building each other up in love.2. We promise to help each other in a friendly way and really listen to each other.3. We will ensure one another’s privacy by not entering the sleeping quarters of others when not invited - no couples will be alone in sleeping quarters. We will deal with problems by going to the person first, then bring along another, and then those in authority.4. We will be fun, friendly and flexible.5. We will obey all rules set by the ORANGENATION YOUNG ADULT SERVANT EVENTincluding: full participation in all events; no use of alcohol (even if over 21) or illegal drugs; always travel in groups of 3 or more.6. We will dress in a way that is God-pleasing.7. We will obey all local, state and federal laws.8. Anyone who does not abide by this covenant could be sent home at their own expense and will not be allowed to further participate in any of the activities.No refunds will be given if someone is asked to leave for breaking the covenant. I promise to live by this covenant as I experience the2020 LCMS YOUNG ADULT SERVANT EVENT JULY 23-26 *
PARTICIPANT AGREEMENT: 1. I understand that a $50 charge per person will be retained for any cancellations made in writing on or before June 1. I also understand that no refunds will be issued if canceled June 2 or after. 2. I understand that the event is from July 23 at 5pm to July 26 at 2pm. 3. I understand that my registration costs covers the cost of the event, food, and housing during the length of the event. I understand housing to mean sleeping in bunk beds, cot or floor at Mt CalvaryLutheran Church. 4. I understand that I am responsible for my own special dietary needs or items during the event. 5. I understand that if I drive for any reason during the event I am responsible for any damage, injury or loss of life caused by the vehicle I am driving. 6. I understand that travel costs are on my own. I will fill out a travel form (emailed to you after you register) once I know my travel plans. I understand there is a $30 fee for a shuttle to and from (roundtrip) the airport.7. I understand that I may have to fill out additional paperwork from other organizations.8. I understand that there is a limited amount of space and that registration is first come/first serve. A full refund will be given if there are no spots available. *
Name (Signature) *
Date *
MM
/
DD
/
YYYY
A copy of your responses will be emailed to the address you provided.
Submit
Never submit passwords through Google Forms.
reCAPTCHA
This form was created inside of PSD-LCMS. Report Abuse